Adopting Your New Normal after a Diagnosis of Metastatic Breast Cancer

by Neal Niznan, MSW, LCSW

"Toto,I have a feeling we’re not in Kansas anymore,” Dorothy tells her little dog in the film The Wizard of Oz as she looks at the surreal landscape of Munchkin Land, realizing that the familiarity of her life has dramatically changed. Maybe you experienced a similar real­ization when you heard the words metastatic disease.

Whether these words were spoken during your initial diagnosis or after many years as a breast cancer survivor, a diagnosis of metastatic breast cancer makes you stop and ponder if your life will ever get back to normal. Unlike Dorothy, who awoke to the relief that her misadventures in Oz were only
a dream, you live the reality of your illness daily, waking each morning
to its new challenges. However, like
Dorothy, you can meet these chal­lenges by adapting to your “new normal.” By focusing on what is im­portant to you, setting manageable goals, and receiving support from
others, you can reclaim a sense of
emotional well-being and normalcy.

Lions and tigers and chemo, oh my!
Deciding to adapt to your new circum­stances, rather than pretend they will simply go away, allows you an oppor­tunity to set positive goals for yourself. Dorothy faced many adversities on her path to the Emerald City – angry apple trees, flying monkeys, and the Wicked Witch of the West, who initially thwarted her plans to get back home. However, Dorothy was goal oriented and knew what she wanted to achieve despite the challenges set before her.

Developing your new normal requires you to identify what you need and want in life, set goals, and work hard to reach those goals.

Neal Niznan

Developing your new normal requires you to identify what you need and want in life, set goals, and work hard to reach those goals. Part of adopting a new nor­mal is figuring out how to maintain as much of your pre-cancer life or regular routine as possible within the context of the changes that are happening around you. This means incorporating the de­mands of treatment along with a need for downtime into your daily schedule.

Don’t forget that Dorothy also took time to dance and sing with her friends along the yellow brick road. Making time for activities that you enjoy –
ones that are creative, nurturing, and fun – is important in bridging the gap between your familiar, pre-cancer life and your new normal.

We’re off to see the Wizard.
It was through the support and dedication of her friends that Dorothy was able to persevere along her difficult journey. Collectively they protected and encour­aged one another and celebrated each accomplishment.

Many survivors say their friends and family don’t really understand what they’re going through: “They don’t hear me. They don’t even know what
I need.” Selecting the right friends and family to support you is integral to maintaining your new normal. Whether you connect with a group of other breast cancer survivors or sit down with close friends to ask if they are able to help, this will ensure that you have the tan­gible and emotional support you need along the way. Choose individuals
who can truly support you, and try
not to pursue those who have a nega­tive attitude or can’t be there for you
in the way you need them to be.

There’s no place like home.
Dorothy’s ultimate goal was to get home to the people and things that she valued most. Likewise, your new normal should incorporate the people and val­ues that give your life a sense of meaning or purpose. In the beginning of the film, Dorothy had become dis­pleased with life on the farm and decided to run away from her situation. As was true for Dorothy, it often takes a life-altering event for us to realize what is truly important in our lives. Focusing on our values and setting goals that reflect them is a step toward creating a new normal that gives you a genuine sense of purpose.

After a diagnosis of metastatic breast cancer, your journey toward adopting
a new normal gives you an opportunity to find strength within yourself as you adapt to changes you did not choose for your life. Setting goals that reflect your values and meet your needs, choosing friends who provide support and comfort, and taking time for enriching activities will help you feel more “at home” with your new normal.

♦ ♦ ♦ ♦ ♦

Neal Niznan is an
oncology social worker in the Department of
Radiation Oncology
at the Hospital of the University of Pennsyl­vania in Philadelphia, PA, and he maintains
a private psychotherapy practice for indi­viduals, couples, and families.

This article was published in Coping® with Cancer magazine,
May/June
2014.